The Arthritis Society is grateful to Dr. Aksa Ahmed, a Chiropractor in Toronto and an Advanced Clinician Practitioner in Arthritis Care, for volunteering her time and expertise to share some winter health and safety tips for seniors with arthritis.
1. Stay active while indoors
Being stuck indoors should not mean less activity. Individuals living with arthritis should exercise on a regular basis. Regular exercise over time has been shown to reduce the pain of arthritis. When trying to exercise on your own:
Be sure to start slowly and with a 10-minute warm up.
Choose an exercise program that is twofold in that it makes muscles stronger and increases your heart rate and breathing. There are many ways to make your muscles stronger, such as with the use of weights or resistance bands. Choose meaningful and purposeful low-impact activities to increase your heart rate and breathing (i.e., walking, using a stationary bicycle, or swimming) as these options are more protective of joints.
Incorporate a 10-minute cool down at the end of your exercise routine.
Before starting a new exercise program it’s important to consult with a healthcare provider to be sure it is safe for you. For more information, visit the Arthritis Society’s Staying Active online guide.
2. Ensure a safe home environment
Individuals living with arthritis often have an increased risk for falls due to poor balance, weak muscles and/or sensory impairments. Oftentimes, falls can be related to unsuspecting hazards in the home. Identifying potential safety risks and making adjustments can considerably reduce your chances of being injured at home. Here are some home safety tips to reduce your risk for falls:
Remove clutter and tripping/slipping hazards such as rugs, cords, spills, and uneven ground. Ensure floor coverings are properly secured or have rubberized non-skid backing. Be alert around pets.
Equip your home with proper lighting and ensure that if you wear visual aids such as glasses that you have them on even while at home.
Utilize mobility aids such as walkers and canes, as required, when walking between rooms. Don’t rush going up or down stairs. Rushing is a major cause of falls.
Use caution while carrying out daily activities around the home. Install grab bars in washrooms, use a shower chair with a hand-held shower head, sit down when getting dressed, and strategically place items in easy to reach areas.
Make sure your bed is not too high or too low, so that it is easy to get in and out. Consider a short bed rail to steady yourself when getting out or to help you with moving around in bed.
Wear supportive footwear and avoid loose clothing.
Take medications as prescribed. Have your pharmacist organize your medication into blister packs or use a dosette (medication organizer) to help keep track of medications. If your medication causes dizziness or sleepiness, adjust your activities to lessen your risk of falling and be sure to consult your doctor or pharmacist if you have ongoing concerns about the side effects and/or questions about proper usage.
Don’t hesitate to ask for help when you need it! Especially with shoveling snow and salting your walkway.
3. Stock up on essentials
It is important to be prepared in case of emergency. Winter storms can be unpredictable, and a bad storm can have you stuck indoors for days at a time. Inclement weather can also lead to frequent power outages. To ensure that you are ready for when there is an emergency, keep your fridge, pantry and medication cabinet stocked with at least 5-7 days’ worth of supplies. Stock up on non-perishables and keep flashlights and batteries handy. Winter storms can drastically affect the mobility of those living with arthritis, so ask a family member, friend or neighbour in advance if they can help with groceries if needed. Alternatively, consider taking advantage of grocery and pharmacy delivery services.
4. Ensure a safe outdoor environment
Individuals living with arthritis should take precautionary measures to ensure their safety when venturing outdoors in the winter. Some people with arthritis can have altered sensation due to underlying nerve or circulation problems such as neuropathy or Raynaud’s phenomenon, respectively. These individuals are more predisposed to frozen fingers, frostbite, and hypothermia. Know the signs and symptoms of these conditions and when to seek medical attention:
Frozen fingers may appear swollen with red spots. To help manage symptoms associated with this condition, dip fingers into lukewarm water and avoid rubbing fingers together.
Frostbites are when skin tissue freezes due to exposure to extreme cold. The fingers may appear blackish-blue with visible blisters. A loss of sensation may also be present. Frostbites can be a medical emergency, as such, call 911 if you or a loved one appears to present with any of these signs and symptoms.
Hypothermia may present with chills, shivering, confusion, clumsiness and/or sudden fatigue after exposure to severe cold weather. Hypothermia can lead to serious health problems such as heart attack, kidney problems, or death. If an individual with an underlying health condition such as arthritis or someone over the age of 65 suffers from hypothermia in the winter, this can be a medical emergency, as such, call 911.
In all cases, shelter the individual suffering from any of the above-mentioned signs and symptoms and ensure that they receive sufficient fluids.
5. Utilize proper shoveling technique
Many individuals living with arthritis have difficulty with safely removing snow and/or ice on their property. Consider having someone available to assist with this task on a regular basis to guarantee a safe exit and entrance into your home. In the event that you take on this task yourself, ensure that you utilize proper shoveling technique or invest in a snow blower. Remember, when it is cold outside, our hearts work twice as hard to keep us warm. As such, strenuous activities such as shoveling snow can place an increased strain on your heart, especially if you have heart disease or a heart condition secondary to your underlying arthritis. Shoveling snow can also be dangerous for individuals with poor balance and those with osteoporosis (“weak and brittle bones”). Osteoporosis can be age-related or due to long term use of medications that can deplete bone quality over time, such as corticosteroids. Tips to keep in mind while shoveling include:
Stretch muscles prior to shoveling to prevent injury. This can include activities like bending from side to side or walking/marching in place.
Keep the shovel close to your body to reduce the load on your back.
When possible, push the snow using the shovel rather than lifting. This also reduces the strain on your back.
In the case where you must lift the snow, ensure that you’re bending at your knees and lifting with your lower body to protect your back. In the case of heavy snowfall, do not attempt to clean down to the ground. Instead, skim the top 6 inches off first and then scoop another 6 inches at a time until the area is completely clear of snow.
Try your best to keep up with snow fall and do not let it collect. Snow is lighter, fluffier and easier to move shortly after it falls.
Frequently alternate your grip on the shovel between keeping your palm under the handle versus over the handle and switch between shoveling right-handed and left-handed to prevent overuse injury.
Take as many breaks as necessary and pause to rest when needed. Don’t feel as if you have to clear the entire driveway/path all in one go.
6. Step outside with the right footwear
Stepping outdoors while wearing the right footwear can help prevent falls. Choose footwear with the following qualities:
Boots that are waterproof and have good quality lining/insulation to keep the feet warm. We lose the most body heat from our head, hands, and feet.
Footwear that is lightweight and comfortable with support for the ankles, wiggle room for the toes, and enough room to accommodate thick socks.
Footwear with non-skid soles. Rubber soles with crevices for traction are often the best selection.
The fastening of your boots will determine how easy they are to put on and remove. Pull-on boots are often the most convenient. Boots with elasticized panels on the sides or elastic laces can stretch for ease of access and provide a snug fit once they are on. Consider using a long-handled shoehorn if you have difficulty with reaching your feet or with hand function.
Visit the Arthritis Society’s article on Choosing the Right Footwear for more tips. In addition to footwear, if you use a mobility aid such as a cane or walker, replace the tips if they are worn out. Consider adding ice pick-like attachments onto the end of your cane for additional traction when walking in the snow.
7. Layer up!
It is extremely important to dress warmly during the winter, both indoors and outdoors. Seniors lose body heat more quickly and can oftentimes be unaware of changes in body temperature, thus making them more susceptible to hypothermia. Dressing in multiple layers will help you keep warm and reduce heat loss. As a guideline, wearing 2-3 thinner layers of loose-fitting clothing usually tends to be warmer than a single layer of thick clothing. When leaving your home, ensure you’re wearing warm socks, a heavy coat/jacket, a warm hat, gloves/mittens, and a scarf to cover your neck, mouth and nose.
8. Be mindful of the winter blues
It’s tough being confined to your home during the winter months, and more so for those who live alone. This winter may be particularly difficult for those living with arthritis due to physical distancing, social isolation, and fears/anxiety about the COVID-19 pandemic. Signs and symptoms of seasonal affective disorder (SAD), also referred to as the “winter blues,” include loss of energy, change in appetite, and an enhanced feeling of lethargy and tiredness. If you or a loved one appears to be suffering from winter blues, having difficulty coping with long hours indoors or social isolation, please contact a healthcare professional to discuss treatment options. You can also visit the Arthritis Society’s Mental Health and Wellness web section for additional information and resources.
9. Always be prepared
In the unfortunate event that you have a fall or accident, it’s helpful to be prepared:
Have all the important phone numbers of family members, emergency contacts and healthcare providers in a convenient place (i.e., near your phone and on your fridge).
Ensure that your telephone is always easily accessible and charged so you can call for help when needed. Make sure that your phone is one that will function when the power goes out.
Ensure that you have a support system in place where a family member, friend or neighbour knows to check on you from time to time. Given the increased risk of falls and injuries, individuals living with arthritis may want to consider a medical alert system that can ensure immediate response in the case of an emergency.
Get familiar with your community resources. The 211 service is available in most regions in Canada and provides information about local government, health, and social services. You can dial 2-1-1 on your phone or visit the service online at www.211.ca.
Content written by:
Aksa Ahmed, DC, ACPAC
Chiropractor, Advanced Clinician Practitioner in Arthritis Care
Rebecca MacDonald Centre for Arthritis & Autoimmune Disease, Mount Sinai Hospital
Special acknowledgement and thanks to Michelle Bridge, OT Reg. (Ont.), ACPAC, Arthritis Rehabilitation & Education Program, for reviewing this article for the Arthritis Society
- Hupin D et al. (2015). Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged ≥60 years: a systematic review and meta-analysis. British J of Sports Med, 49 (19): 1262-1267. DOI: 10.1136/bjsports-2014-094306
- Sparling PB et al. (2015). Recommendations for physical activity in older adults. BMJ, 350:h100. DOI: 10.1136/bmj.h100
- UpToDate. (2020). Patient education: Arthritis and Exercise (The Basics). UpToDate. https://www.uptodate.com/contents/arthritis-and-exercise-the-basics
- Nelson et al. (2007). Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9):1094-105. DOI: 10.1161/CIRCULATIONAHA.107.185650
- Morey, M. (2020). Physical activity and exercise in older adults. UpToDate. https://www.uptodate.com/contents/physical-activity-and-exercise-in-older-adults
- Health in Aging. (2019). Tip Sheet: Winter Safety For Older Adults. Health in Aging. https://www.healthinaging.org/tools-and-tips/tip-sheet-winter-safety-older-adults
- Zafren, K and Mechem C. (2020). Frostbite: Emergency care and prevention. UpToDate. https://www.uptodate.com/contents/frostbite-emergency-care-and-prevention
- Hinrichs T and Brach M. (2012). The general practitioner’s role in promoting physical activity to older adults: a review based on program theory. Curr Aging Sci, 5(1):41-50. DOI: 10.2174/1874609811205010041
- Hamer M et al. (2014). Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med, 48(3):239-43. DOI: 10.1136/bjsports-2013-092993
- Zafren, K and Mechem C. (2020). Accidental hypothermia in adults. UpToDate. https://www.uptodate.com/contents/accidental-hypothermia-in-adults
- Iliades, C. (2012). Creating a Safer Home for the Osteoarthritis Patient. Everyday Health. https://www.everydayhealth.com/osteoarthritis/creating-a-safe-home.aspx
- Schur, P and Gibofsky, A. (2020). Nonpharmacologic therapies and preventive measures for patients with rheumatoid arthritis. UpToDate. https://www.uptodate.com/contents/nonpharmacologic-therapies-and-preventive-measures-for-patients-with-rheumatoid-arthritis?search=lifestyle%20modification%20arthritis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
- Sayre, C. Adapting Your House When You Have Arthritis. Arthritis Foundation. https://www.arthritis.org/health-wellness/healthy-living/daily-living/life-hacks-tips/adapting-your-house
- Mayo Clinic. (2020). Arthritis pain: Do’s and don’ts. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20046440
- Nowell, B. (2019). Rheumatoid Arthritis and Winter Weather. News Medical Life Sciences. https://www.news-medical.net/health/Rheumatoid-Arthritis-and-Winter-Weather.aspx
- Canadian Centre for Occupational Health and Safety. (2017). OSH Answers Fact Sheets: Shovelling. CCOHS. https://www.ccohs.ca/oshanswers/ergonomics/shovel.html
- Freivalds, A. (2010). The ergonomics of shoveling and shovel design- a review of the literature. Ergonomics, 29(1), 3-18. DOI: 10.1080/00140138608968236
- Avery, D. (2020). Seasonal affective disorder: Epidemiology, clinical features, assessment, and diagnosis. UpToDate. https://www.uptodate.com/contents/seasonal-affective-disorder-epidemiology-clinical-features-assessment-and-diagnosis